| NPI | 1952741191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.295725) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 16660-040) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |